| NPI | 1255744694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN CNP4386) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R1470846) |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2019-12-05 |